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Original Article

J Rheum Dis 2016; 23(1): 47-54

Published online February 29, 2016

© Korean College of Rheumatology

한국인 류마티스관절염과 골관절염 환자의 위장관 위험인자와 비스테로이드항염제 사용 비교

이은영1ㆍ홍승재2ㆍ박용범3ㆍ박경수4ㆍ최찬범5ㆍ이창근6ㆍ송 란7ㆍ이윤종8ㆍ서창희9ㆍ김현아10, 민준기11ㆍ윤종현12ㆍ박 원13ㆍ정원태14ㆍ김근태15ㆍ최정윤16ㆍ강성욱17ㆍ박용욱18ㆍ류완희19, 이상헌20

1서울대학교 의과대학 내과학교실 류마티스내과, 2경희의료원 류마티스내과, 3연세대학교 의과대학 세브란스병원 내과학교실 류마티스내과, 4가톨릭대학교 성빈센트병원 류마티스내과, 5한양대학교 류마티스병원 류마티스내과, 6울산대학교 의과대학 서울아산병원 내과학교실 류마티스내과, 7강동경희대학교병원 류마티스내과, 8분당서울대학교병원 류마티스내과, 9아주대학교병원 류마티스내과, 10한림대학교성심병원 류마티스내과, 11가톨릭대학교 부천성모병원 류마티스내과, 12가톨릭대학교 의정부성모병원 류마티스내과, 13인하대학교 의과대학 내과학교실 류마티스내과, 14동아대학교병원 류마티스내과, 15고신대학교복음병원 류마티스내과, 16대구가톨릭대학교 의과대학 내과학교실 류마티스내과, 17충남대학교 의학전문대학원 내과학교실, 18전남대학교 의과대학 류마티스내과학교실, 19전북대학교 의학전문대학원 내과학교실 류마티스내과, 20건국대학교병원 류마티스내과

Received: October 6, 2015; Revised: January 21, 2016; Accepted: January 30, 2016

Gastrointestinal Risk Factors and Non-steroidal Anti-inflammatory Drugs Use in Rheumatoid Arthritis and Osteoarthritis Patients in Korea

Eun Young Lee 1, Seung-Jae Hong2, Yong-Beom Park3, Kyung-Su Park4, Chan-Bum Choi5, Chang-Keun Lee6, Ran Song7, Yun Jong Lee8, Chang Hee Suh9, Hyun Ah Kim10, Jun Ki Min11, Chong-Hyeon Yoon12, Won Park13, Won Tae Chung14, Geun-Tae Kim15, Jung-Yoon Choe16, Seong Wook Kang17, Yong-Wook Park18, Wan-Hee Yoo19, Sang-Heon Lee20

Author Info. +

1Division of Rheumatology, Seoul National University College of Medicine, Seoul, 2Department of Rheumatology, Kyung Hee University Medical Center, Seoul, 3Division of Rheumatology, Severance Hospital, Yonsei University College of Medicine, Seoul, 4Department of Rheumatology, The Catholic University of Korea, St. Vincent's Hospital, Suwon, 5Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, 6Division of Rheumatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 7Department of Rheumatology, Kyung Hee University Hospital at Gangdong, Seoul, 8Department of Rheumatology, Seoul National University Bundang Hospital, Seongnam, 9Department of Rheumatology, Ajou University Hospital, Suwon, 10Department of Rheumatology, Hallym University Sacred Heart Hospital, Anyang, 11Department of Rheumatology, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, 12Department of Rheumatology, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, 13Division of Rheumatology, Inha University School of Medicine, Incheon, 14Department of Rheumatology, Dong-A University Hospital, Busan, 15Division of of Rheumatology, Kosin University Gospel Hospital, Busan, 16Division of Rheumatology, Catholic University of Daegu School of Medicine, Daegu, 17Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, 18Department of Rheumatology, Chonnam National University Medical School, Gwangju, 19Division of Rheumatology, Chonbuk National University Medical School, Jeonju, 20Department of Rheumatology, Konkuk University Medical Center, Seoul, Korea

Correspondence to : Sang-Heon Lee
Department of Rheumatology, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-ju, Seoul
05030, Korea. E-mail：shlee@kuh.ac.kr

Received: October 6, 2015; Revised: January 21, 2016; Accepted: January 30, 2016

Abstract

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Objective. The aim of this study was to examine and compare the gastrointestinal (GI) risk factors and treatment patterns of rheumatoid arthritis (RA) and osteoarthritis (OA) patients in Korea. Methods. This was a cross-sectional, observational study on RA and OA patients taking non-steroidal anti-inflammatory drugs (NSAIDs) for at least 1 month. A total of 1,896 patients (981 RA patients, 915 OA patients) were recruited from 20 university hospitals. Data were collected through medical records and patient surveys. GI risk factors included age, prolonged (over 3 months) or high-dose use of NSAIDs, alcohol drinking, smoking, use of aspirin, anticoagulants or glucocorticoids, comorbidities, and history of Helicobacter pylori infection or other GI complications. Treatment patterns were classified according to groups using, selective cyclooxygenase (COX)-2 inhibitors± gastro-protective agents, non-selective COX-2 inhibitors+proton pump inhibitor, or non-selective COX-2 inhibitors± other gastro-protective agents. Results. GI risk factors were highly present in both RA and OA patients. The proportion of prolonged use of NSAIDs, smoking, and glucocorticoid use were higher in RA patients (p＜0.001). The proportion of comorbidities and use of aspirin were higher in OA patients (p＜0.001). The remaining GI risk factors were present in similar proportions in both groups. Use of selective COX-2 inhibitors or gastro-protective agents was higher in RA patients. Conclusion. Prolonged use of NSAIDs and concomitant glucocorticoid use were higher in RA patients, while comorbidities and concomitant aspirin use were predominant in OA patients. These results will provide insights for use in development of future guidelines for proper selection of NSAIDs and effective prevention of GI complications in arthritis patients. (J Rheum Dis 2016;23:47-54)

Keywords Rheumatoid arthritis, Osteoarthritis, Gastrointestinal risk factors, Non-steroidal anti-inflammatory agents

Article

Original Article

J Rheum Dis 2016; 23(1): 47-54

Published online February 29, 2016

Copyright © Korean College of Rheumatology.

한국인 류마티스관절염과 골관절염 환자의 위장관 위험인자와 비스테로이드항염제 사용 비교

이은영1ㆍ홍승재2ㆍ박용범3ㆍ박경수4ㆍ최찬범5ㆍ이창근6ㆍ송 란7ㆍ이윤종8ㆍ서창희9ㆍ김현아10, 민준기11ㆍ윤종현12ㆍ박 원13ㆍ정원태14ㆍ김근태15ㆍ최정윤16ㆍ강성욱17ㆍ박용욱18ㆍ류완희19, 이상헌20

1서울대학교 의과대학 내과학교실 류마티스내과, 2경희의료원 류마티스내과, 3연세대학교 의과대학 세브란스병원 내과학교실 류마티스내과, 4가톨릭대학교 성빈센트병원 류마티스내과, 5한양대학교 류마티스병원 류마티스내과, 6울산대학교 의과대학 서울아산병원 내과학교실 류마티스내과, 7강동경희대학교병원 류마티스내과, 8분당서울대학교병원 류마티스내과, 9아주대학교병원 류마티스내과, 10한림대학교성심병원 류마티스내과, 11가톨릭대학교 부천성모병원 류마티스내과, 12가톨릭대학교 의정부성모병원 류마티스내과, 13인하대학교 의과대학 내과학교실 류마티스내과, 14동아대학교병원 류마티스내과, 15고신대학교복음병원 류마티스내과, 16대구가톨릭대학교 의과대학 내과학교실 류마티스내과, 17충남대학교 의학전문대학원 내과학교실, 18전남대학교 의과대학 류마티스내과학교실, 19전북대학교 의학전문대학원 내과학교실 류마티스내과, 20건국대학교병원 류마티스내과

Received: October 6, 2015; Revised: January 21, 2016; Accepted: January 30, 2016

Gastrointestinal Risk Factors and Non-steroidal Anti-inflammatory Drugs Use in Rheumatoid Arthritis and Osteoarthritis Patients in Korea

Eun Young Lee 1, Seung-Jae Hong2, Yong-Beom Park3, Kyung-Su Park4, Chan-Bum Choi5, Chang-Keun Lee6, Ran Song7, Yun Jong Lee8, Chang Hee Suh9, Hyun Ah Kim10, Jun Ki Min11, Chong-Hyeon Yoon12, Won Park13, Won Tae Chung14, Geun-Tae Kim15, Jung-Yoon Choe16, Seong Wook Kang17, Yong-Wook Park18, Wan-Hee Yoo19, Sang-Heon Lee20

1Division of Rheumatology, Seoul National University College of Medicine, Seoul, 2Department of Rheumatology, Kyung Hee University Medical Center, Seoul, 3Division of Rheumatology, Severance Hospital, Yonsei University College of Medicine, Seoul, 4Department of Rheumatology, The Catholic University of Korea, St. Vincent's Hospital, Suwon, 5Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, 6Division of Rheumatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 7Department of Rheumatology, Kyung Hee University Hospital at Gangdong, Seoul, 8Department of Rheumatology, Seoul National University Bundang Hospital, Seongnam, 9Department of Rheumatology, Ajou University Hospital, Suwon, 10Department of Rheumatology, Hallym University Sacred Heart Hospital, Anyang, 11Department of Rheumatology, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, 12Department of Rheumatology, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, 13Division of Rheumatology, Inha University School of Medicine, Incheon, 14Department of Rheumatology, Dong-A University Hospital, Busan, 15Division of of Rheumatology, Kosin University Gospel Hospital, Busan, 16Division of Rheumatology, Catholic University of Daegu School of Medicine, Daegu, 17Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, 18Department of Rheumatology, Chonnam National University Medical School, Gwangju, 19Division of Rheumatology, Chonbuk National University Medical School, Jeonju, 20Department of Rheumatology, Konkuk University Medical Center, Seoul, Korea

Correspondence to:Sang-Heon Lee
Department of Rheumatology, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-ju, Seoul
05030, Korea. E-mail：shlee@kuh.ac.kr

Received: October 6, 2015; Revised: January 21, 2016; Accepted: January 30, 2016

Abstract

Objective. The aim of this study was to examine and compare the gastrointestinal (GI) risk factors and treatment patterns of rheumatoid arthritis (RA) and osteoarthritis (OA) patients in Korea. Methods. This was a cross-sectional, observational study on RA and OA patients taking non-steroidal anti-inflammatory drugs (NSAIDs) for at least 1 month. A total of 1,896 patients (981 RA patients, 915 OA patients) were recruited from 20 university hospitals. Data were collected through medical records and patient surveys. GI risk factors included age, prolonged (over 3 months) or high-dose use of NSAIDs, alcohol drinking, smoking, use of aspirin, anticoagulants or glucocorticoids, comorbidities, and history of Helicobacter pylori infection or other GI complications. Treatment patterns were classified according to groups using, selective cyclooxygenase (COX)-2 inhibitors± gastro-protective agents, non-selective COX-2 inhibitors+proton pump inhibitor, or non-selective COX-2 inhibitors± other gastro-protective agents. Results. GI risk factors were highly present in both RA and OA patients. The proportion of prolonged use of NSAIDs, smoking, and glucocorticoid use were higher in RA patients (p＜0.001). The proportion of comorbidities and use of aspirin were higher in OA patients (p＜0.001). The remaining GI risk factors were present in similar proportions in both groups. Use of selective COX-2 inhibitors or gastro-protective agents was higher in RA patients. Conclusion. Prolonged use of NSAIDs and concomitant glucocorticoid use were higher in RA patients, while comorbidities and concomitant aspirin use were predominant in OA patients. These results will provide insights for use in development of future guidelines for proper selection of NSAIDs and effective prevention of GI complications in arthritis patients. (J Rheum Dis 2016;23:47-54)

Keywords: Rheumatoid arthritis, Osteoarthritis, Gastrointestinal risk factors, Non-steroidal anti-inflammatory agents

JRD
Jan 01, 2025 Vol.32 No.1, pp. 1~7
COVER PICTURE
Cumulative growth of rheumatology members and specialists (1980~2024). Cumulative distribution of the number of the (A) Korean College of Rheumatology members and (B) rheumatology specialists. (J Rheum Dis 2025;32:63-65)
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